Uworld NTK_Week2 Flashcards
Ehlers-Danlos Syndrome ~w/ what defect?
abnormal collagen formation.
Bone Mets:
Osteolytic (lucent): ?
OSteoblastic (sclerotic): ?
Osteolytic: d/t osteoclast stimulation, tend to represent aggressive cancer.
Osteoblastic: d/t osteoblasts, more indolent course
Metastatic prostate cancer has what type of bone lesions?
Osteoplastic (sclerotic)
hypersensitivity to intradermal injections of tobacco extracts ~ ?
Thromboangiitis obliterans (buerger’s disease)
always in a smoker
what det the DURATION of the QRS?
bundle branch conductivity.
What does the pacemaking in severe bradycardia?
purkinje system
absent p waves, irregular R-R intervals, narrow ORSs ==> ?
A-fib
AV nose refractory period regulares the number of atrial impulses that reach the ventricles.
Breast milk is insufficient in what vitamin/nutrients for a newborn?
Vitamin D and K.
What vitamin is high in colostrum and breast milk?
Vitamin A
Hemodynamically significant ASD ==> ?
chronic pulmonary hypertension as a result of left-to-right Add to dictionary shunting.
~Eisenmenger syndrome
Transference: ? (psych)
unconscious shifting of emotion associated with a significant person from one’s past to another person in the present. (can be positive or negative)
DOC for trigeminal neuralgia?
Carbamazepine
triad of abnormalities ~w/ ventricular pre-excitation?
- shorten PR-interval
- Delta-wave
- widen QRS interval
accessory AV conduction pathway (wolff-parkinson-white)
SIBO decreases what?
most vitamin (B12, A, D, E)
SIBO increases production of folic acid and vitamin K
Aneurysm of the internal carotid a. can lateral impinge what?
optic chiasm –> ipsilateral nasal heminopia; d/t damage of uncrossed optic nerve fibers from the temporal portion of the retina.
Sertoli-Leydig tumor (stroma [sex cord]) ==> ??
increased androgen ==> hirsutism, clitoromegaly in women
What can bind to both antithrombin and thrombin to allow antithrombin to inactive thrombin?
ONLY unfractionated heparin!
Decerebrate (extensor) posturing is d/t ???
damage to brainstem at/below the level of the red nucleus (midbrain tegmentum, pons)
glycogen accumulation in lysosomes and severe cardiomegaly ==> ?
Pompe disease.
“enlarged lysosomes containing periodic acid-Schiff (PAS)-positive material”
fucked Acid alpha-glucosidase
bounding peripheral pulses and head bobbing with each heartbeat ~ ?
Aortic regurgitation;
causes an increase in total stroke volume with abrupt distension and rapid falloff of peripheral atrial pulses, resulting in wide pulse pressure.
beta-adrenergic agonist with predominant activity on Beta-1 receptors, used to increase HR and cardiac contractility leading to what?
increase myocardial oxygen consumption.
How long does it take for total ischemia in cardiac tissue to become irrev.?
after 30 minute.
loss of cardiomyocyte contractility occurs within (how long) after onset of total ischemia?
60 seconds
V/Q ratio is highest where?
highest at the Apex, decreases as you move DOWN to the BASE!
What causes the coronary sinus to become dilated?
any factor that increases the right atrial pressure; pulmonary HTN –> elevated right heart pressures.
the coronary sinus freely communicates with the right atrium.
W.R.T allergic asthma, what are the only substances that have pharmacologic receptor antagonist that offer therapeutic benefit?
Leukotrienes (LTC4, LTD4, LTE4)
&
acetylcholine
Use of phentolamine?
phentolamine is a alpha-1 blocking agent used to prevent tissue necrosis during NE infusion.
NE is an alpha-1 agonist, that causes severe vasoconstriction.
While waiting for a lung transplant d/t to pulm. HTN caused by intimal fibrosis, what drug should you give the pt.?
Bosentan; endothelin-receptor antagonist that blocks the effects of endothelin (a potent vasoconstriction that also stimulate endothelial proliferation)
Etanercept MOA?
inhibits TNF activity
anti-inflammatory agent for RA, Psoriasis, psoriatic arthritis.
When AV nodal cells become the pacemaker, what do you see?
- ORS narrowing
- atria and ventricles depolarize independently (AV dissociation)
- AV node produces HR of 45-55 bpm.
MC site of traumatic aortic rupture (due to rapid deceleration/car crash) is at ?
Aortic isthmus.
b/c it is tethered by the ligamentous arteriosum and is relatively fixed and immobile.
left ventricular end-diastolic volume is aka ?
preload
What does mitral regurg do to preload?
Increase
What is the interaction of cortisol and other hormones called?
Permissiveness; when one hormone allows another hormone to exert its maximal effect. (via upregulartion)
What is the difference between additive and synergistic effects of two drugs?
additive: sum of the two drugs = to their activity individually.
Synergistic: the sum of the two drugs > than the two drugs by themselves.
What is the MOA of glucagon binding?
activate GPCR to increase intracellular cAMP. increase release of intracellular Ca2+ increasing cardiac contractility and HR.
What synthesizes the collagen and other matrix comp. in an atherosclerotic plaque?
VSMCs
where are fibroblast found in blood vessels?
tunica intima
Why do peds squat during a Tet Spell?
to increase systemic vascular resistance and decrease right-to-left shunting ==> increasing pulmonary blood flow and improving oxygenation status.
What type of CV dysfunc. occurs in hypertensive heart disease?
Diastolic dysfunc. ==> concentric ventricular hypertrophy and decreased left ventricular chamber size.
What type of pt. would benefit from a cardioselective beta-blocker?
coronary artery disease and HF.
What is the first line DOC for Tx essential hypertension in the general pop?
Hydrochlorothiazide
What drug is useful for a pt with both PBH and HTN?
alpha-1-blockers: doxazosin, prazsosin, terazosin.
ST elevations in leads II, III, and aVF indicate what?
transmural ischemia of the INFERIOR wall of the left ventricle.
i.e. occlusion of the right coronary artery,.
Anteroseptal transmural ischemia will show what in the ECG and what vessel would be fucked?
proimal LAD.
ST elevation in leads V1-V4.
Occlusion in the LCX produces what on ECG?
ST elevation in V5 & V6 (maybe I and aVL)
transmural ischemia of the lateral wall of the left Ventricle.
What are the drugs that can cause drug-induced lupus? (5)
- hydralazine
- Procainamide
- isoniazid
- minocycline (tetracycline-class)
- quinidine
How do macrophages reduce atherosclerotic plaque stability?
Macrophages secrete metalloproteinases which degrade ECM proteins (collegen)
What causes claudication (muscle pain due to exercise, relieved by rest)?
obstruction of blood flow d/t stenotic lesion produced by atheroma, which are LIPID_FILLED INTIMAL plaques that bulge into the arterial lumen.
Onion-like concentric thickening of arteriolar walls ~ ?
hyperplastic ateriolOsclerosis. d/t malignant HTN.
Medial band-like calcifications ~ ?
Monckeberg’s medial calcific sclerosis, or medial calcinosis.
calcified deposits in muscular arteries. aSx b/c they do not narrow vessel lumen. ~w/ > 50yrs.
What do you use to Tx organophosphate poisoning?
Pralidoxime (form of atropine)
Need to do so ASAP, b/c aging of the organo-phosphate-complex makes it irreversible.
cytoplasmic processes that send signals to and exchange nutrients and waste products?
gap junctions
zonula occludens aka ?
tight junctions
what are observed at the apices of granular cells and consist of two closely adherent cytoplasmic membranes without and intervening space?
tight junction = zonula occludens.
__________ extend from the basal surfaces of keratinocytes in the stratified squamous epithelium to attach to the basal lamina.
Hemidesmosomes
What hormone remains normal until latte-stage hypothyroidism?
serum T3.
TSH is elevated at all stages of hypOthyroidism
______________ is a type of exchange of genetic material that alters the genetics composition of the HOST cells but NOT that progeny virions.
Transformation
What provides the collateral blood flow of the lungs?
pulmonary and bronchial arteries.
prevents lung infarction.
what is the precursor of fructose?
Sucrose
why is CN7 ~ ear Sx?
stapedius nerve is a branch of the facial nerve.
loss of speech and motor skills, deceleration of head growth, and stereotypic hand movements AFTER a period nor normal development
Rett syndrome; mainly affects girls. ~ with MECP2 gene